In U.S. Pat. No. 4,188,953 entitled Hemostatic Clip, issued on Feb. 19, 1980, and assigned to the present assignee, hemostatic clips adapted for utilization in the present invention and similar devices is disclosed.
In the above-referenced copending U.S. patent application entitled Hemostatic Clip Applicator, and assigned to the present assignee, a Hemostatic Clip Applicator for the strangulation of tubular members in a rapid and automatic manner is disclosed. That application is directed, in part, to a device having a main body, a clip cartridge, actuating handles, and clip deforming jaws. Disposed within the clip cartridge are a plurality of hemostatic clips, and a clip feed means which moves clips to the clip deforming jaws where the clips are deformed about a blood vessel or the like.
While the applicator noted in the preceding paragraph provides a novel method for automatically closing blood vessels and other fluid ducts, it requires the manual feeding of a hemostatic clip into the deforming jaws by the forward movement of one of two handles. That is, to operate that device, the surgeon must first move one of the handle portions to a forward position so as to load a hemostatic clip in the deforming jaws, and then return that handle portion to its neutral position. Once the surgeon has located the hemostatic clip around the tubular member to be closed, he squeezes both handle portions together resulting in the crimping of a clip about the blood vessel. When the surgeon is ready to close another blood vessel, this same sequence of moving one handle portion forward and then rearward must be repeated so as to sequentially load and close a clip.
In the other above referenced copending U.S. patent application entitled Spring Activated Hemostatic Clip Applicator, and assigned to the present assignee, an alternative hemostatic clip applicator is disclosed which also provides for the rapid and automatic strangulation of tubular members. That application is directed, in part, to a device in which energy is first stored and then released to automatically deliver a clip into the jaws of the instrument. In the illustrated embodiment of that application, with a slight upward movement of one of the finger loops, a clip is almost instantaneously delivered to the jaws of the instrument by the release of energy stored in a spring. Then, simply by moving the finger loops toward one another, the clip which has been loaded in the jaw portions can be deformed around a blood vessel or the like. Simultaneously with this crimping of the hemostatic clip, the instrument is again storing energy in the spring so that when another clip is needed, it can be readily available.
While this last noted clip applicator also provides a novel method for automatically closing blood vessels and other fluid ducts, it has been found that a noticeable additional force has often been necessary to "cock" the spring over and above that which is required to crimp the clip. This has resulted, in part, from the utilization of a spring which is capable of exerting a force sufficient to overcome frictional forces exerted by elements within the clip magazine. In particular, in the illustrated embodiment of this latter application, the clips in the magazine are pushed forward by a pawl which is engaged by a forward moving member which is coupled to the spring. The pawl also prevents the clips from moving backwards while the spring is being cocked. In that embodiment, the pawl is prevented from moving backward by the frictional engagement of two side arms disposed on either side of the pawl with the magazine housing walls. This frictional engagement of the pawl sidearms must be overcome by the spring in order to drive the pawl and consequently, the clips, forward. Since the force necessary to cock the spring increases the force necessary to close the finger loops and crimp the clip, it is desirable to minimize the requisite strength of the spring to minimize the cocking force of the spring.
It is toward the refinement of the devices disclosed in the copending U.S. patent applications noted above that the present invention is directed, and more specifically, toward a device which rapidly, yet almost effortlessly, loads and crimps a hemostatic clip in the deforming jaws of the instrument.
2. Field of the Invention
The invention relates to the field of devices useful in the application of hemostatic clips, and more specifically, to devices for the application of hemostatic clips used in the strangulation of blood vessels and other fluid ducts.
3. Prior Art
In a typical surgery procedure, a great many veins, arteries, and other blood vessels must be severed and closed. This is often a difficult and time consuming procedure since many vessels are located in obscure areas where there is little room in which to work. Thus, it is apparent that a device which would reduce the time required for closure of blood vessels would be a great benefit to both surgeon and patient.
One prior art attempt to provide a device which can more rapidly close a blood vessel is suggested by Jarvik, U.S. Pat. No. 4,146,466. The Jarvik device has a channel in the main body of the instrument which is integral with one of the jaws of the instrument. In the Jarvik device, a clip pusher moves the lower most clip in a clip stack through the channel in the main body to the jaws at the far end of the instrument. However, the pusher does not enter the jaws of the Jarvik instrument, but merely abuts the aft-most portion of the jaws without sliding therebetween. As a result, the jaws of the instrument are approximately the same length as the length of the clips, which can reduce visibility for the surgeon. In addition, upon application of the hemostatic clip by the Jarvik instrument, the pusher is positively prevented from returning from its farthest most position. Also, the Jarvik patent does not disclose an instrument which utilizes a spring loaded mechanism so as to move rapidly and accurately a clip from an internal clip magazine to the jaw portions of the instrument.
Accordingly, it is a general object of the present invention to provide an improved hemostatic clip applicator device for the strangulation of blood vessels and the like.
It is another object of the present invention to provide an improved automatic hemostatic clip applicator device which provides high visibility to the surgeon.
It is another object of the present invention to provide an improved hemostatic clip applicator device which rapidly and automatically feeds clips to its forward portion and then provides deformation of the clips about blood vessels.
It is yet another object of the present invention to minimize the friction in the operation of an automatic clip feeding hemostatic clip applicator.
It is still another object to provide an improved automatic clip feeding hemostatic clip applicator which simulates the feel of a manual hemostatic clip applicator.
It is another object to provide an improved cartridge which minimizes resistance to the advancement of each clip.